The move away from the ‘one size fits all’ public services is set to gather momentum following publication of a strategy for ‘Realizing Britain’s Potential’. But changing the way services are delivered is proving difficult.The report from the Cabinet Office presents an in-depth analysis of future challenges for the government covering a range of issues from globalisation to public service reform.
Delivering more personalised and professional services is presented in the report as both a challenge and an opportunity. Tailoring services to the specific needs of individuals will require a number of systemic changes over the next decade. A new wave of innovative practice around personalising services needs to be fostered. For example direct payments to disabled and older people to allow them to arrange and buy their own support services instead of getting them from their local council is seen as one way to achieve this aim.
The move towards meeting the diverse needs and choices of users by personalizing care will be fostered by developing a more diverse supply of providers. This will include greater involvement of social enterprises and charities.
The difficulties of making major shifts in strategy are highlighted bythe current problems with direct payments and by a failure to open up contracts to the third sector. The personalized budgets are failing to cover the cost of the care. See Publicnet 18 February 2008. In the first test of a major procurement exercise only one third sector organisation was successful in securing a contract for the Department for Work and Pension’s pathways to work programme. See Publicnet 26 November 2007.
The report also quotes an example of a personalized approach to healthcare in the United States which has pioneered successful prevention and management of long term conditions. Through a combination of self care and shared care and extensive use of information technology, the carers and families are able to collaborate to meet individual needs. The company providing the service invests 2 per cent in information technology. This compares with the NHS which only invests 0.5per cent in technology.
The report is available from the Cabinet Office. http://www.cabinetoffice.gov.uk/upload/assets/www.cabinetoffice.gov.uk/strategy/strategic_challenges.pdf